Abstract

The phenomenon of Alice in Wonderland Syndrome is not considered a disease in its own right but usually occurs as an accompanying symptom of a migraine attack or as a precursor of an epileptic seizure in the form of an aura with pronounced visual perceptual disturbances [1]. However, an Alice in Wonderland syndrome can also be caused by the Epstein-Barr virus, influenza virus [18], drugs [3] or encephalitis [2]. The term "Alice in Wonderland syndrome" was named after the children's book Alice in Wonderland by Lewis Carroll and coined by John Todd as a possible, but not essential, concomitant of migraine and epilepsy [1]. Carroll suffered from migraines himself; it is believed that his experiences with the condition served as inspiration for the hallucination-like effects described in his work [1]. In addition, Carroll's narrative has been discussed as a description of a trip following consumption of mind-altering drugs. In one of the most famous sequences in the book, Alice changes size by biting off pieces from different sides of a mushroom. However, there is no evidence of drug use by Lewis Carroll. Alice in Wonderland syndrome results in changes in the perception of one's surroundings [6,7]. These changes include both micropsia and macropsia (everything appears reduced or enlarged), as well as altered auditory perception, altered tactile perception, an altered sense of time. The syndrome is particularly common in children. Attacks are often shorter and may also be completely painless, although accompanying symptoms such as nausea, vomiting, and sensitivity to light and sound is more pronounced. Neurological deficits may occur so that the affected child begins to hallucinate. He or she perceives his or her body as larger or smaller and/or begins to see "fantastic images“. The changes in perception can severely affect affected individuals, causing them to become disoriented and "unable to find their way around." In extreme cases, falls and other accidents may occur. The perceptual disturbances can lead to Alice in Wonderland syndrome being confused with other mental disorders or misinterpreted as "craziness". The primary focus is the treatment of the underlying condition, such as symptomatic treatment of migraine. Recent publications shed light on sexual abuse in childhood as the origin of AIWS-like visual disturbances [4,5].

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